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Gastroenterology > Upper GI tract > Flashcards

Upper GI tract Flashcards

1
Q

What is digestion?

A

Process of breaking down macromolecules to allow absorption

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2
Q

What is absorption?

A

The process of moving nutrients and water across a membrane

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3
Q

What are the components of the GI system?

A 
Salivary glands 
Oesophagus
Sublingual glands
Submandibular glands
Stomach
Duodenum
Colon
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4
Q

What are the foregut structures?

A 
Liver
Pancreas
Oesophagus 
Stomach
Billary system
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5
Q

What are the midgut structures?

A

Small intestine

Part of large

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6
Q

What are the hind gut structures?

A

Colon

Rectum

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7
Q

What are the layers of the gut wall?

A

Mucosa (epithelium)
Submucosa
Musularis
Serosa/Adeventitia

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8
Q

What is the function of the mucosa?

A

Secretory and absorptive functions

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9
Q

What is the function of the submucosa?

A

Contains blood vessels and capillaries that facilitate exchange

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10
Q

What is the function of the muscularis?

A

Facilitates peristalis
Inner layer- circular muscle that constricts the bowel and divides bowel into segments so that food stays in segments for some time to prevent food rushing through

Longitudinal layer- propagates food through GI tract

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11
Q

What is the function of the serosa?

A

Connective tissue

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12
Q

Describe the numbers of teeth

A

8 incisors
4 canines
8 premolars
12 molars

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13
Q

What are the muscles in the oral cavity?

A

Masseter- largest jaw muscle
responsible for biting
Several others that control the position of mandible

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14
Q

What do the salivary glands do?

A

Secrete lipase and amylase

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15
Q

What do the tongue muscles do?

A

Propagate the food into the pharynx

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16
Q

What does the pharynx lead to?

A

Oesophagus

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17
Q

What do the intrinsic muscles of the tongue do?

A

fine motor control & moving food

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18
Q

What do the extrinsic muscles of the tongue do?

A

gross movement of tongue (in, out, up & down)

Assists mechanical digestion

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19
Q

What is the function of the oesophagus?

A

Conduit for food, drink & swallowed secretions from pharynx to stomach

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20
Q

What is the structure and function relationship of the oesophageal epithelium?

A

Non-keratinising
‘Wear & Tear’ lining (extremes of temp. & texture)
Lubrication – Mucus secreting glands (& saliva)

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21
Q

What muscles are in the oesophagus?

A

Upper and lower oesophageal sphincter
Play a role in how food gradually moves into the oesophagus
Function not fully understood

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22
Q

What is the structure and function relationship of the oesophageal muscles?

A

Tonically active

Swallowing centre

23
Q

What is gastro-oesophageal reflex disease?

A

Acid refluxes into the oesophagus
‘Heart-burn’
Burning sensation

24
Q

What results from acid reflux?

A 
Inflammation of the oesophagus 
Red streaks- oesophagitis 
After many years lining changes from squamous to columnar epithelium to protect oesophagus against acid 
"Metaplasia"- Barret's oesophagus
Pre-malignant condition
25
Q

What should be done in a patient with barret’s?

A

Surveillance endoscopsy every 2-3 years

To detect dysplasia

26
Q

What is the function of the inner circular muscle?

A

Divided oesophagus into segments

Pushes food through

27
Q

What is the function of the longitudial muscles?

A

Facilitates peristalsis

28
Q

What are the main features of the gastro-oesophageal junction?

A

Reflux – prevented by diaphragm

Epithelial transition

Gastric folds - rugae

29
Q

What is the diaphragmatic hiatus?

A

The diaphragm pinches the lower end of the oesophagus

Helps prevent acid reflux

30
Q

How else is acid reflux prevented on a regular basis?

A

Angle between oesophagus and stomach is acute
2cm of oesophagus in abdo
Negative pressure in thorax
Positive pressure in abdo
The differential keeps the 2cm in abdo in collapsed state

31
Q

What is a hiatus hernia?

A

Hiatus becomes large
Stomach migrates into chest Keeps gastro-oesophageal junction open
Causes acid reflux

32
Q

What is a giant hiatus hernia?

A

Entire stomach migrates to chest
Collapsed lungs
Reduced lung capacity
Breathlessness

33
Q

Why are gastric folds present?

A

Absorbing function
Folds contains villi to increase the SA
Allows for the absorption of plentiful nutrients

34
Q

What are the 4 phases of swallowing?

A

0: Oral Phase
1: Pharyngeal phase
2: Upper oesophageal phase
3: Lower oesophageal phase

35
Q

What happens during oral the phase?

A

Chewing & saliva prepare bolus

Both oesophageal sphincters constricted

36
Q

What happens during the pharyngeal phase?

A

Pharyngeal musculature guides food bolus towards oesophagus

Both oesophageal sphincters open

37
Q

What happens during the upper oesophageal phase?

A

Upper sphincter closes
Superior circular muscle rings contract & inferior rings dilate
Sequential contractions of longitudinal muscle

38
Q

What happens during the lower oesophageal phase?

A

Lower sphincter closes as food passes through

39
Q

What are the functions of the stomach?

A

Breaks food into smaller particles (acid & pepsin)
Holds food, releasing it in controlled steady rate into duodenum
Kills parasites & certain bacteria

40
Q

What are the different parts of the stomach?

A

Cardia and pyloric region
Body and fundus
Antrum

41
Q

How much acid is secreted by the stomach a day?

A

2L/day

42
Q

What is the function of stomach acid?

A

Breaks down food and starts process of digestion

43
Q

What is segmentation?

A 
Keeps food in stomach
80% stomach contractions
Weaker.
 Fluid chyme towards Pyloric sphincter
Solid chyme pushed back to body
Stretching activates enteric NS
44
Q

What is peristalsis?

A

20% stomach contractions
Propels chyme towards colon
more powerful as moves from LOS to pyloric sphincter
ANS essential

45
Q

What are the main cells present in the stomach?

A

Chief cells

Parietal cells

46
Q

What are the main features of the gastric chief cells?

A

Protein-secreting epithelial cell
Abundant RER- involved in synthetic production of proteins
Golgi packaging and modifying for export
Masses of apical secretion granules
Secretes pepsinogen to be converted to pepsin

47
Q

What are the main features of the parietal cells?

A

Active pump
Many mitochondria (requires lots of ATP)
Cytoplasmic tubulovesicles (contain H+/K+ ATPase)
Internal canaliculi (extend to apical surface)
Tubulovesicles fuse with membrane
Microvilli project into canaliculi
Release HCL into lumen

48
Q

How is HCL produced?

clarify

A

CO2 come from capillaries into parietal cells
Mixes with H2O catalysed by carbonic anhydrase
Potassium enters cell
Gets secreted into gastric lumen
Balance maintained by Na+ entering capillaries
Potassium exchanged with H+ ion through H+/K+ ATPase pump
Bicarbonic acid goes back into circulation
H+ combines with CL-

49
Q

What is the main function of HCL?

A

converts pepsinogen to pepsin

50
Q

What is gastrin?

A

Hormone secreted by G-cells in pyloric antrum
Stimulates HCL secretion from parietal cell
Stimulates histamine release from chromaffin cells

51
Q

What is a gastrinoma?

A

Benign tumour of gastrin producing cells
Often in pancreas
Presents with persistent and multiple ulcers

52
Q

What stimulates parietal cells?

A

Neurostimulation: Thought, sight, smell & taste of food via vagus nerves

Hormonal stimulation: pancreas secreting gastrin acts on parietal cells

Local stimulation: local reflexes via neural plexus’

53
Q

What is the function of enterohormones?

A

Play in a role in the enter-gastric reflex

Suppresses or enhances production of HCL and gastrin

Gastroenterology (12 decks)

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